Speech and Language

Why Every ADHD Child Needs A Speech Language Evaluation

October 16, 2021

As many as 9 out of 10 children with ADHD have difficulty with some aspect of speech or language.

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Hi there! Katie here. I know I  have the absolute, best job. OK, I’m kidding.

Sort of.

I’m a speech language pathologist who gets to work with a team of AMAZING psychologists. We collaborate daily on the best practices for kids with ADHD.  I love having both disciplines work together, and we’ve developed a  FREE GUIDE to help you navigate ADHD treatments from our combined perspectives!

One of the first things we tell families who reach out to us is: If your child has a diagnosis of ADHD, a speech language evaluation is an important part of understanding the whole picture of your child’s strengths and needs. 

We know there are SO many questions when it comes to parenting, so today, I want to share the primary questions parents have about speech language evaluations for children with ADHD. 


Really? Every ADHD child needs a speech language evaluation? 

Most people understand how important language testing is for autistic children. Since social communication differences are part of autism, parents are usually sent to an SLP for additional testing. The connection between ADHD and language, however, is not always common knowledge. This is why we say that every ADHD child needs a speech language evaluation.


Russell Barkley, a leading researcher in ADHD, has cited that as many as ⅔ of children with ADHD also have speech and language disorders, with some studies indicating that the prevalence is as high as 90%.


It’s hard to imagine that as many as 9 out of 10 children with ADHD may have difficulties with some aspect of speech, language, or communication!  Children with ADHD are creative and can be very thoughtful. We don’t want to miss out on this, so understanding them is a gift!



What areas of speech and language can be affected in children with ADHD?

Executive Function 

Executive function is one of the main areas of language that is impacted in children with ADHD. If you’re looking for information specifically on executive function, some of our favorite posts and podcasts episodes are:

Executive functions help us to set goals, stay on track, and finish. They help us stay calm when frustrated, change plans, and manage time. A speech language evaluation can help pinpoint specific areas of  needed growth.  That way, goals can be developed to address these. Even more important: Many SLPs can help your child improve their executive function skills through evidence-based treatment!

Beyond the executive functions, there are many other areas of speech, language, and social skills that can be impacted in children with ADHD.


Social Communication 

Social skills are often impacted in children with ADHD.  If your child is having trouble paying attention, these social processes may move too quickly and will likely feel confusing. A speech language evaluation will assess your child’s social language skills, such as inferencing and problem solving. 


Language Processing 

Language processing refers to the way we understand and recall information (think of it as the “input” of language).  As you know, children with ADHD can struggle to follow directions or listen to long lectures from teachers. This can be the result of several factors, including working memory issues and inattention. During speech language testing, our goal is to look at exactly what types of language the child can understand. That way, therapy can be focused on any specific skill-based deficits.

  • Vocabulary: Do they have difficulty understanding a specific term, like “left/right” or “before/after,” which causes them to make a lot of errors when following directions?
  • Length and Complexity: Do they struggle more with complex sentences and grammar structures?
  • Visualization: Is it easier for them to understand information when there are pictures? Or are they able to comprehend information without pictures?  


Expressive Language 

Simply put, expressive language refers to language “output” or the way a person can express themselves. For children with ADHD, there are several areas of expressive language that are often impacted. 

  • Narrative language: The ability to tell a story that makes sense and is in the correct order. I often hear from parents who say, “I ask them what they did today, and they just shrug and say I don’t know!” Parents are inevitably frustrated, because their child absolutely does know what they did during the day!  For children with ADHD, it can be extremely difficult to start at the beginning, give enough background information, keep the events in order, and stay on topic while telling a story. 
  • Word retrieval: The ability to quickly and accurately find the right words. Children with ADHD will sometimes use a closely related word instead of the word they are actually looking for. For example, they may say “timer thingy” for “alarm clock”. In other instances, children with ADHD have trouble choosing specific words and instead use nonspecific words like, “stuff” or “those ones” which can make it hard to understand their ideas.  
  • Grammar: The rules that govern our language can be challenging for children with ADHD to learn. Sometimes they can make grammatical errors when talking as well as when writing.


Speech Sounds

Some children with ADHD also have speech/articulation challenges. When a child makes errors on specific sounds or groups of sounds, this is often classified as a speech sound disorder. Because children with ADHD often struggle with self-monitoring, they may not self-correct these errors as readily. In this case, speech therapy can teach the correct pronunciation of sounds. (For more specific information about speech disorders, click here) Speech issues are important to address at a young age if possible. There is a strong link between pervasive speech sound errors and long-term reading difficulty, such as Dyslexia. 


Reading and Writing 

Many children with ADHD struggle with some aspect of reading or writing. ADHD and Dyslexia co-occur at very high rates, with some estimates ranging from 25-40%. Writing is affected because it is such a complex process which requires several skills to work together at the same time. Reading and writing are, in many ways, the academic forms of listening and speaking. A speech language pathologist can evaluate reading and writing to help parents understand exactly where the breakdowns are occurring. 


Where can I get a speech language evaluation? 

While we believe every ADHD child needs a speech language evaluation, they should be conducted by a certified speech language pathologist (SLP). If ADHD is suspected or confirmed, it’s important to collaborate with a psychologist or have the SLP review their report to understand a bigger picture of the child (for example, cognitive skills or behavior history). 

  • If there are concerns at school, your child may be able to get speech language testing done in the school environment. Typically school therapy will be focused primarily on any areas of academics that are impacted, such as processing language in the classroom (sequencing complex instructions), writing (planning and editing), or social skills.  
  • Private practice/medical speech language testing will often be more in-depth due to fewer time constraints. It may be covered by insurance, but can also be on the expensive side. If you are looking for a private speech language evaluation, check with your insurance company and ask around for referrals to a good practice in your area. 


I know, this is A LOT of information but we know your momma heart, wants to get equipped with the knowledge to help your children shine! Please let us know if you have more questions about speech language evaluations; we would love to answer them for you on the blog or over social media. 


If your child has been diagnosed with ADHD, or you suspect they may have ADHD, check out our FREE ADHD Parenting Guide. Or, if you are ready to take the leap, join our online parenting course about ADHD. You can watch Creating Calm from anywhere in the world, at a time that works for you… in your jammies!


Have a beautiful week,




Disclaimer: The contents of this site are opinions of The Childhood Collective PLLC partners unless otherwise noted. The information on this site is not intended to diagnose, treat, or prevent any type of medical condition and is not intended as personalized medical/psychological advice. Any decision you make regarding you and your family’s health and medical treatments should be made with a qualified healthcare provider.

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  1. […] reaction isn’t frustration. Instead, I take time to be really curious: did they completely understand the expectation? Often times, the answer is “no” and that’s ok! That helps me understand what is […]

  2. […] you are worried about your child’s language or their writing, a thorough speech language evaluation is essential to understanding (and supporting) your child’s needs! A speech language evaluation […]

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